ATI Pediatrics: Cardiovascular and Hematologic Disorders Practice
Exam 2026 |Questions |Answers |Rationales
1. A nurse is caring for an infant with a large Ventricular Septal Defect (VSD).
Which of the following clinical manifestations should the nurse expect?
A. Cyanosis that worsens with crying
B. Weak femoral pulses compared to upper extremities
C. A loud holosystolic murmur at the left lower sternal border
D. A machine-like murmur heard throughout the cardiac cycle
Answer: C
Rationale: A VSD typically presents with a loud holosystolic murmur heard best at the left
lower sternal border due to the high-pressure left-to-right shunting of blood.
2. Which of the following medications is commonly used to close a Patent
Ductus Arteriosus (PDA) in a premature infant?
A. Indomethacin
B. Prostglandin E1
C. Alprostadil
D. Digoxin
Answer: A
Rationale: Indomethacin, a prostaglandin inhibitor, is often administered to facilitate the
closure of a PDA in preterm infants.
,3. A nurse is monitoring an infant with Tetralogy of Fallot who begins to have a
hypercyanotic spell (Tet spell). Which action should the nurse take first?
A. Administer 100% oxygen via face mask
B. Administer morphine sulfate subcutaneously
C. Place the infant in the knee-chest position
D. Prepare for immediate intubation
Answer: C
Rationale: The first action for a hypercyanotic spell is to place the infant in the knee-chest
position to increase systemic vascular resistance and improve pulmonary blood flow.
4. A child is diagnosed with Coarctation of the Aorta. Which assessment finding
is characteristic of this condition?
A. Severe chest pain on exertion
B. Bounding peripheral pulses in all extremities
C. Clubbing of the fingers and toes
D. Blood pressure higher in the arms than in the legs
Answer: D
Rationale: Coarctation of the aorta causes narrowing near the ductus arteriosus, resulting
in high blood pressure and bounding pulses in the arms, but low blood pressure and weak
pulses in the lower extremities.
5. A nurse is providing teaching to parents of a child with Rheumatic Fever.
Which of the following is the most important management goal?
A. Managing joint pain with ibuprofen
B. Reducing the child’s fever
C. Resolving the skin rash (erythema marginatum)
D. Preventing permanent cardiac valve damage
Answer: D
, Rationale: Rheumatic Fever is an inflammatory disease that can lead to permanent
scarring of the heart valves, so preventing carditis is the primary goal.
6. A child is admitted with Kawasaki Disease in the acute phase. Which of the
following medications should the nurse expect to administer?
A. Intravenous Immunoglobulin (IVIG) and high-dose Aspirin
B. Acyclovir and Prednisone
C. Amoxicillin and Warfarin
D. Furosemide and Enalapril
Answer: A
Rationale: IVIG and high-dose aspirin are the standard treatments for Kawasaki Disease to
reduce inflammation and prevent coronary artery aneurysms.
7. What is the primary pathophysiology behind Sickle Cell Anemia?
A. Production of immature white blood cells
B. Substitution of an amino acid in the hemoglobin chain
C. Iron deficiency leading to small red blood cells
D. Lack of Factor VIII in the blood
Answer: B
Rationale: Sickle cell anemia is caused by the substitution of valine for glutamic acid in the
beta-globin chain, resulting in HgbS which sickles under low oxygen conditions.
8. A nurse is teaching a parent of a child with Iron Deficiency Anemia about
liquid iron supplement administration. Which instruction is correct?
A. Mix the iron with a glass of milk to improve taste
B. Give the iron only if the child has a high-fiber meal
C. Administer the iron through a straw to prevent tooth staining
D. Stop the medication if the child’s stools turn black
Answer: C
Exam 2026 |Questions |Answers |Rationales
1. A nurse is caring for an infant with a large Ventricular Septal Defect (VSD).
Which of the following clinical manifestations should the nurse expect?
A. Cyanosis that worsens with crying
B. Weak femoral pulses compared to upper extremities
C. A loud holosystolic murmur at the left lower sternal border
D. A machine-like murmur heard throughout the cardiac cycle
Answer: C
Rationale: A VSD typically presents with a loud holosystolic murmur heard best at the left
lower sternal border due to the high-pressure left-to-right shunting of blood.
2. Which of the following medications is commonly used to close a Patent
Ductus Arteriosus (PDA) in a premature infant?
A. Indomethacin
B. Prostglandin E1
C. Alprostadil
D. Digoxin
Answer: A
Rationale: Indomethacin, a prostaglandin inhibitor, is often administered to facilitate the
closure of a PDA in preterm infants.
,3. A nurse is monitoring an infant with Tetralogy of Fallot who begins to have a
hypercyanotic spell (Tet spell). Which action should the nurse take first?
A. Administer 100% oxygen via face mask
B. Administer morphine sulfate subcutaneously
C. Place the infant in the knee-chest position
D. Prepare for immediate intubation
Answer: C
Rationale: The first action for a hypercyanotic spell is to place the infant in the knee-chest
position to increase systemic vascular resistance and improve pulmonary blood flow.
4. A child is diagnosed with Coarctation of the Aorta. Which assessment finding
is characteristic of this condition?
A. Severe chest pain on exertion
B. Bounding peripheral pulses in all extremities
C. Clubbing of the fingers and toes
D. Blood pressure higher in the arms than in the legs
Answer: D
Rationale: Coarctation of the aorta causes narrowing near the ductus arteriosus, resulting
in high blood pressure and bounding pulses in the arms, but low blood pressure and weak
pulses in the lower extremities.
5. A nurse is providing teaching to parents of a child with Rheumatic Fever.
Which of the following is the most important management goal?
A. Managing joint pain with ibuprofen
B. Reducing the child’s fever
C. Resolving the skin rash (erythema marginatum)
D. Preventing permanent cardiac valve damage
Answer: D
, Rationale: Rheumatic Fever is an inflammatory disease that can lead to permanent
scarring of the heart valves, so preventing carditis is the primary goal.
6. A child is admitted with Kawasaki Disease in the acute phase. Which of the
following medications should the nurse expect to administer?
A. Intravenous Immunoglobulin (IVIG) and high-dose Aspirin
B. Acyclovir and Prednisone
C. Amoxicillin and Warfarin
D. Furosemide and Enalapril
Answer: A
Rationale: IVIG and high-dose aspirin are the standard treatments for Kawasaki Disease to
reduce inflammation and prevent coronary artery aneurysms.
7. What is the primary pathophysiology behind Sickle Cell Anemia?
A. Production of immature white blood cells
B. Substitution of an amino acid in the hemoglobin chain
C. Iron deficiency leading to small red blood cells
D. Lack of Factor VIII in the blood
Answer: B
Rationale: Sickle cell anemia is caused by the substitution of valine for glutamic acid in the
beta-globin chain, resulting in HgbS which sickles under low oxygen conditions.
8. A nurse is teaching a parent of a child with Iron Deficiency Anemia about
liquid iron supplement administration. Which instruction is correct?
A. Mix the iron with a glass of milk to improve taste
B. Give the iron only if the child has a high-fiber meal
C. Administer the iron through a straw to prevent tooth staining
D. Stop the medication if the child’s stools turn black
Answer: C
